The nurse is caring for a client who suffers from frequent blood clots and is currently taking argatroban. Which of the following conditions in the client's medical history would require them to take argatroban?
Heparin induced thrombocytopenia.
Ventricular Dysfunction
Myocardial infarction
Hepatotoxicity
The Correct Answer is A
A) Heparin induced thrombocytopenia (HIT): Argatroban is an indirect thrombin inhibitor specifically used for anticoagulation in patients with HIT. This condition involves a significant drop in platelet counts due to heparin therapy, and argatroban is an appropriate alternative for preventing thrombosis in these patients.
B) Ventricular Dysfunction: While managing anticoagulation may be important in patients with ventricular dysfunction, this condition does not specifically necessitate the use of argatroban. Other anticoagulants may be used based on the clinical situation.
C) Myocardial infarction: Although anticoagulation may be warranted in the setting of a myocardial infarction, argatroban is not specifically indicated for this condition. Other antithrombotic therapies, such as aspirin or heparin, are more commonly used.
D) Hepatotoxicity: Argatroban is metabolized in the liver, so caution is warranted in patients with liver dysfunction. Hepatotoxicity itself would not be a reason to use argatroban; rather, it may require close monitoring or adjustment of dosage.
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Correct Answer is D
Explanation
A) Pulse oximetry of 92%: While a pulse oximetry reading of 92% is slightly below normal, it is not a definitive reason to hold verapamil. This reading indicates mild hypoxemia, but it does not directly contraindicate the use of verapamil. Other factors should be considered before making a decision based solely on this value.
B) Pulse of 78: A pulse rate of 78 beats per minute is within the normal range for adults and does not warrant holding verapamil. This finding alone does not indicate any immediate concerns related to the administration of the medication.
C) Respiratory rate of 12: A respiratory rate of 12 breaths per minute is within the normal range for adults. This finding does not provide any indication that verapamil should be withheld. It is important to consider other clinical factors when assessing the appropriateness of medication administration.
D) History of myocardial infarction a week ago: Verapamil, a calcium channel blocker, can have significant effects on cardiac function. Administering it to a client who recently experienced a myocardial infarction (heart attack) could exacerbate cardiac issues and lead to complications. Therefore, it is crucial to hold the medication and consult with the healthcare provider before proceeding.
Correct Answer is C
Explanation
A) "Acts on the beta cells within the heart and lungs to regulate cardiac rhythm.": This statement is incorrect because calcium channel blockers do not primarily act on beta cells. Instead, they block calcium channels in cardiac and smooth muscle, which affects heart contractility and conductivity.
B) "Increases heart rate and increases myocardial contractility.": Calcium channel blockers typically do the opposite; they decrease heart rate and myocardial contractility by inhibiting calcium entry into the heart muscle cells. Therefore, this statement does not accurately describe their mechanism of action.
C) "Reduces the contractility and conductivity of the heart.": This statement accurately reflects the action of calcium channel blockers. By blocking calcium entry, these medications decrease myocardial contractility and slow down electrical conduction through the heart, which can help manage dysrhythmias.
D) "Increase oxygen to the systemic circulation.": While calcium channel blockers can improve blood flow and reduce myocardial oxygen demand by decreasing heart workload, their primary action does not directly focus on increasing oxygen delivery to systemic circulation. Their primary role is in managing heart contractility and rhythm.